Orthopedics

What is Shoulder Arthroscopy?

A shoulder arthroscopy is used to diagnose and treat shoulder injuries. It can be used to diagnose problems with ligaments, tendons, inflammation, fractures, and the presence of loose objects. It is a minor surgery, which is usually done as an outpatient. During this surgery, the doctor makes several small incisions (cuts) on the top of the shoulder and inserts an arthroscope (a small tube-like lighted instrument) into the shoulder. This allows the doctor to see the entire shoulder joint. Small instruments can also be inserted through the arthroscope that can be used, in some cases, to repair certain injuries or problems.

What do I need to do before my surgery?

Shower the night before your surgery and in the morning before you come to the
hospital with the special soap you will be given.
Do not eat or drink anything after midnight the night before your surgery.
Please do not chew gum. (This raises the level of acid in your stomach.)
Take a shower the morning of your surgery.
You may brush your teeth and rinse your mouth as long as you do not swallow any water.
If you take medicine for your heart, blood pressure, or asthma you may take this with a small sip of water before you come to the hospital. If you take medicine and/or insulin for diabetes you need to ask your doctor if you should take this.
Remove all fingernail polish.
Remove all jewelry including body piercings.
Do not wear any makeup.
If you will be checking into the hospital on the day of your surgery:
Wear comfortable, loose fitting clothes that are easy to put on. Your shirt should be loose fitting through the sleeves and shoulders and button up the front.
Bring all medicines that you are taking to the hospital with you.
Do not bring valuables or large amounts of money with you to the hospital.
Have a responsible adult drive you to the hospital, stay during your surgery, and drive you home. You will not be allowed to drive yourself home.

What can I expect the day of surgery?

If you are checking into the hospital on the day of your surgery, after you have been to the Admitting Office, you will be taken to a room. This may not be the room where you will be taken after surgery.
You will be given a hospital gown and asked to remove all of your clothes including underwear and socks. Put on the gown opening in the back.
You will be asked to remove all jewelry, glasses, hairpieces, contact lenses, dentures, prosthesis, and hearing aids.
You will be asked questions about your medical history. Many of these will be the same questions that you have already been asked. Please know that we need to ask these again so that we can give you the best possible care.
You may go straight to the operating room or you may go to the Pre-Anesthesia Unit (PAU). If you go to the PAU, you will be there for about one hour before your surgery.
Your nurse will tell your family where to wait.
You will be asked several times on which shoulder the doctor is going to operate. This shoulder will have a mark placed on it with a special pen.
You will have an area on your upper chest as well as your shoulder and upper arm shaved and washed. It may be wrapped in sterile towels.
You will have an IV (needle in your arm for fluids) started and you will be given medicine that will help you relax.
Someone from anesthesia will talk with you about your health history and the type of anesthesia that will be used.
You will be taken to the operating room. This room will be cold and your nurse will give you a warm blanket.
The operating room staff will include your doctor, his assistant, an anesthetist (the person who will put you to sleep), a circulating nurse, and a scrub nurse. All of these people are there to care for you and no one else.
You will have sticky pads placed on your chest so that the staff can watch your heart. A blood pressure cuff will be placed on your arm so that your blood pressure can be checked. A device called a pulse oximeter will be put on your finger. It will tell how much oxygen is in your blood.
The anesthetist will put a soft mask over your face. This will give you plenty of oxygen.
You will be given medicine in your IV that will relax you to the point of sleep. You will not wake up during your surgery and you will not feel pain.
After your surgery starts, the nurse will call your family and tell them how you are doing.
The nurse will call your family at least one time an hour. How long the surgery will take will depend on how much repair the doctor needs to do. This surgery usually takes from thirty minutes to two hours.
When the surgery is over, anesthetist will give you medicine that will help you to wake up. You will go to the Recovery Room. You will be in this room for 30 minutes to an hour. The doctor will talk with your family.
You will have your blood pressure, pulse, temperature, and oxygen level checked. The nurse will check your dressing for any signs of bleeding and will feel of the pulses and temperature in your hand and wrist.
When you wake up, you may have on a shoulder immobilizer that was put on at the end of your surgery. This is sometimes used to keep your shoulder still after surgery. If your doctor wants you to wear a shoulder immobilizer, you will be taught how to use it.
If you are in pain or if you feel sick to your stomach please tell the nurse so that you can be given medicine.
When you are awake you will be taken to your room.
Call for the nurse to help you the first time that you need to get out of the bed. Do not try to get up without help.
When you are fully awake, if you are not sick to your stomach, you will be given something to eat and to drink.
You will be asked to go to the bathroom and empty your bladder (make water).
After you eat, drink, and empty your bladder, you will, most likely, be able to go home.
You will not be allowed to drive yourself home.

What should I do when I go home?

Your doctor will give you guidelines to follow. Be sure to follow his or her instructions.
Your doctor will tell you how to care for your wound and how long to leave on your dressing. Keep your dressing clean and dry. Do not take a shower until after your dressing has been removed. Do not swim or take a tub bath until your wounds are completely healed.
If you have been given a shoulder immobilizer or arm sling, you will be instructed how to use it. It is important that you wear it as instructed.
Do not drive or operate machinery until your doctor tells you that it is safe to do so.
Do not drink alcohol for at least 24 hours.
Do not lift anything weighing more than a few ounces with your affected arm until after your follow-up appointment.
You will be given exercises to do on your shoulder. Do these as the doctor tells you.
Be sure to keep your follow-up appointment with your doctor at his office after surgery.

Call your doctor if:

Your temperature is above 100.5° twice.
You notice any bleeding or drainage on your dressing.
You have any redness or swelling in the area of your surgery.
You have numbness in your arm or hand or if you notice a change in the color of your fingers.
You have pain not relieved by your pain medicine.
You have any other questions or concerns.